Apocrine Breast Cancer: Unique Features of a Predominantly Triple-Negative Breast Cancer
Tóm tắt
Invasive apocrine carcinoma is a rare breast cancer that is frequently triple negative. Little is known about the characteristics of its molecular subtypes. We compared the incidence, demographics, and clinicopathologic features of this cancer with non-apocrine carcinomas stratified by molecular subtype. Women with invasive apocrine cancer were retrospectively identified from the Surveillance, Epidemiology, and End Results (SEER) database. Clinicopathologic and demographic features were compared with non-apocrine carcinomas, both overall using data from 2004 to 2017 and stratified by molecular subtypes using data from 2010 to 2017. The life table method was used to determine the 7-year breast cancer-specific survival. Compared with non-apocrine cancers, apocrine cancers presented at a younger age, with larger, higher-grade tumors that were much more likely to be triple negative (50% vs. 11%) or human epidermal growth factor receptor 2 (HER2)-positive (28% vs. 15%) and less likely to be luminal (22% vs. 74%); however, the 7-year survival was the same at 85%. The characteristics varied dramatically by molecular type. Compared with non-apocrine triple-negative, apocrine triple-negative patients were less likely to be African American and were much older, with smaller, lower-grade tumors and much better survival (86% vs. 74%). In contrast, compared with luminal non-apocrine, apocrine luminal patients had larger, higher-grade tumors and worse survival (79% vs. 89%). Invasive apocrine carcinomas have more aggressive features than non-apocrine carcinomas but the breast cancer-specific survival is the same. Half of these apocrine tumors are triple negative but these have more favorable features and much better survival than non-apocrine triple-negative cancers.
Tài liệu tham khảo
Krompecher E. Apocrine carcinoma of the breast. Beitr Path Anat. 1916;62:403.
Frable WJ, Kay S. Carcinoma of the breast. Histologic and clinical features of apocrine tumors. Cancer. 1968;21(4):756–63.
Tan PH, Ellis I, Allison K, et al. The 2019 World Health Organization classification of tumours of the breast. Histopathology. 2020;77(2):181–5.
Tsutsumi Y. Apocrine carcinoma as triple-negative breast cancer: novel definition of apocrine-type carcinoma as estrogen/progesterone receptor-negative and androgen receptor-positive invasive ductal carcinoma. Jpn J Clin Oncol. 2012;42(5):375–86.
Mills AM, Gottlieb CE, Wendroth SM, Brenin CM, Atkins KA. Pure apocrine carcinomas represent a clinicopathologically distinct androgen receptor-positive subset of triple-negative breast Cancers. Am J Surg Pathol. 2016;40(8):1109–16.
Robinson JL, Macarthur S, Ross-Innes CS, et al. Androgen receptor driven transcription in molecular apocrine breast cancer is mediated by FoxA1. EMBO J. 2011;30(15):3019–27.
Shah PD, Gucalp A, Traina TA. The role of the androgen receptor in triple-negative breast cancer. Women’s Health (Lond). 2013;9(4):351–60.
Cochrane DR, Bernales S, Jacobsen BM, et al. Role of the androgen receptor in breast cancer and preclinical analysis of enzalutamide. Breast Cancer Res. 2014;16(1):R7.
Kaya H, Bozkurt SU, Erbarut I, Djamgoz MB. Apocrine carcinomas of the breast in Turkish women: hormone receptors, c-erbB-2 and p53 immunoexpression. Pathol Res Pract. 2008;204(6):367–71.
Moinfar F, Okcu M, Tsybrovskyy O, et al. Androgen receptors frequently are expressed in breast carcinomas: potential relevance to new therapeutic strategies. Cancer. 2003;98(4):703–11.
Varga Z, Zhao J, Ohlschlegel C, Odermatt B, Heitz PU. Preferential HER-2/neu overexpression and/or amplification in aggressive histological subtypes of invasive breast cancer. Histopathology. 2004;44(4):332–8.
Vranic S, Tawfik O, Palazzo J, et al. EGFR and HER-2/neu expression in invasive apocrine carcinoma of the breast. Mod Pathol. 2010;23(5):644–53.
Vranic S, Marchiò C, Castellano I, et al. Immunohistochemical and molecular profiling of histologically defined apocrine carcinomas of the breast. Human Pathol. 2015;46(9):1350–9.
d’Amore ES, Terrier-Lacombe MJ, Travagli JP, Friedman S, Contesso G. Invasive apocrine carcinoma of the breast: a long term follow-up study of 34 cases. Breast Cancer Res Treatment. 1988;12(1):37–44.
Gilles R, Lesnik A, Guinebretière JM, et al. Apocrine carcinoma: clinical and mammographic features. Radiology. 1994;190(2):495–7.
Tan PH, Schnitt SJ, van de Vijver MJ, Ellis IO, Lakhani SR. Papillary and nuroendocrine breast lesions: the WHO stance. Histopathology. 2015;66(6):761–70.
Lambot MA, Eddafali B, Simon P, Fayt I, Noël JC. Metastasis from apocrine carcinoma of the breast to an endometrial polyp. Virchows Archiv. 2001;438(5):517–8.
Vranic S, Schmitt F, Sapino A, et al. Apocrine carcinoma of the breast: a comprehensive review. Histol Histopathol. 2013;28(11):1393–409.
Lehmann-Che J, Hamy AS, Porcher R, et al. Molecular apocrine breast cancers are aggressive estrogen receptor negative tumors overexpressing either HER2 or GCDFP15. Breast Cancer Res. 2013;15(3):R37.
Vranic S, Feldman R, Gatalica Z. Apocrine carcinoma of the breast: a brief update on the molecular features and targetable biomarkers. Bosnian J Basic Medi Sci. 2017;17(1):9–11.
Dellapasqua S, Maisonneuve P, Viale G, et al. Immunohistochemically defined subtypes and outcome of apocrine breast cancer. Clin Breast Cancer. 2013;13(2):95–102.
Meattini I, Pezzulla D, Saieva C, et al. Triple negative apocrine carcinomas as a distinct subtype of triple negative breast cancer: a case-control study. Clinical Breast Cancer. 2018;18(5):e773–80.
Wu W, Wu M, Peng G, Shi D, Zhang J. Prognosis in triple-negative apocrine carcinomas of the breast: a population-based study. Cancer Med. 2019;8(18):7523–31.
Elimimian EB, Samuel TA, Liang H, Elson L, Bilani N, Nahleh ZA. Clinical and demographic factors, treatment patterns, and overall survival associated with rare triple-negative breast carcinomas in the US. JAMA Netw Open. 2021;4(4):e214123.
Gromov P, Espinoza JA, Gromova I. Molecular and diagnostic features of apocrine breast lesions. Expert Rev Mol Diagn. 2015;15(8):1011–22.